Efficacy of Sub Gingivally Delivered Probiotic with Lactobacillus Salivarius, Lactobacillus Reuteri, Lactobacillus Plantarum as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis- A Clinical and Microbiological Study

Abstract

Introduction: Periodontal disease is a chronic microbial infection characterized by persistent inflammation, connective tissue breakdown and alveolar bone destruction^. The presence of pathogenic bacteria, the absence of so‑called “beneficial bacteria” and the susceptibility of the host are the main etiological factors of periodontal diseases. The administration of beneficial bacteria i.e. probiotics with antimicrobial and anti-inflammatory properties is one of several novel approaches being considered as an adjunct treatment for the management of periodontitis and may offer a low risk, inexpensive and easy-to-use treatment option.

Objectives: To evaluate the effect of sub gingivally delivered probiotics as an adjunct to scaling and root planing (SRP) on periodontal and microbiological parameters using N-benzoyl-dL-arginine-2-napthylamide (BANA) test in periodontally compromised individuals.

Methods: The study was carried out on 22 sites in different quadrants with Probing Pocket Depth (PPD) ≥ 5mm. At baseline, patients received SRP followed by subgingival delivery of probiotic to test site and placebo to control site. Plaque Index (PI), Gingival Index (GI), Sulcus Bleeding Index (SBI), Pocket Probing Depth (PPD), Relative Attachment Level (RAL) recorded at baseline, 1 month, 3 month and microbial analysis done using BANA test at baseline and 3 months.

Results: The study showed statistically significant improvement in both clinical measures as well as in the colony forming units (CFUs).

Conclusions: Probiotic strains were found effective in improving the clinical measures and could serve as a useful adjunct to SRP in periodontally compromised individuals.